The Significance of 99mTc-MAA SPECT/CT Liver Perfusion Imaging in Treatment Planning for 90Y-Microsphere Selective Internal Radiation Treatment

• DOI: 10.2967/jnumed.109.074559
• Publication Date: 2010-07-22T03:52:16Z
• Authors: Hojjat Ahmadzadehfar; Amir Sabet; Kim Biermann; Marianne Muckle; Holger Brockmann; Christiane Kuhl; Kai Wilhelm; Hans-Jürgen Biersack; Samer Ezziddin
• Keywords: Spect imaging

Selective internal radiation therapy (SIRT), a catheter-based liver-directed modality for treating primary and metastatic liver cancer, requires appropriate planning to maximize its therapeutic response minimize side effects. (99m)Tc-macroaggregated albumin (MAA) scanning should precede the detect any extrahepatic shunting lung or gastrointestinal tract. Our aim was compare ability of SPECT/CT with that planar imaging SPECT in detection localization (99m)Tc-MAA accumulation evaluate impact on SIRT treatment added value angiography this setting.Ninety diagnostic hepatic angiograms were obtained 76 patients different types cancer. All images reviewed retrospectively MAA deposition following order: planar, non-attenuation-corrected SPECT, SPECT/CT. Review follow-up abdominal served as reference standards.Extrahepatic detected by imaging, 12%, 17%, 42% examinations, respectively. The sensitivity detecting 32%, 41%, 100%, respectively; specificity 98%, 93%, respective positive predictive values 92%, 89%, negative 71%, 73%, 100%. plan changed according results 7.8%, 8.9%, 29% patients, respectively.In pre-SIRT planning, is valuable identifying visceral sites at risk postradioembolization complications.